This document defines and discusses emergency obstetrical and neonatal care (EmONC). EmONC refers to medical interventions that treat life-threatening complications during pregnancy and childbirth in order to save lives. Specifically, EmONC saves around 280,000 women and 3 million newborns per year and prevents millions of disabled conditions. There are two types of EmONC: basic EmONC (BEmONC) which provides 7 essential medical interventions, and comprehensive EmONC (CEmONC) which provides the same interventions plus additional procedures like transfusions and surgery. While EmONC has been available for decades in developed countries, in low-income countries where most maternal and neonatal deaths occur, health systems

1. EMERGENCE OBSTETRICAL AND
NEONATAL CARE
By Jean Bosco HENRI

2. Definition
• Package of medical interventions
– To treat life-treatening complications during
pregnancy and Child birth

3. Importance
• Save lives around 280,000 women/year
• Save lives of 3M of newborns/year
• Prevention of Millions of disabled conditions
– Timely
– Effective EmONC

4. Type of EmONC
• Basic Emergency obstetrics and Newborn care
(BEmONC)
• Comprehensive Emergency obstetrics and
Newborn care (CEmONC)

5. Basic Emergency obstetrics and
Newborn care (BEmONC)
• Seven essential medical interventions
– antibiotics to prevent puerperal infection
– anticonvulsants for treatment of eclampsia and
preeclampsia
– uterotonic drugs
– manual removal of the placenta
– assisted or instrumental vaginal delivery
– removal of retained products of conception; and
– neonatal resuscitation

6. Comprehensive Emergency obstetrics
and Newborn care (CEmONC)
– antibiotics to prevent puerperal infection
– anticonvulsants for treatment of eclampsia and
preeclampsia
– uterotonic drugs
– manual removal of the placenta
– assisted or instrumental vaginal delivery
– removal of retained products of conception; and
– neonatal resuscitation
• Transfusions, surgery
• neonatal intubation and advanced resuscitation

7. PREVALENCE
• accessible in developed countries for decades
• in low-income countries, where 99% of
maternal and neonatal deaths occur, health
systems may not have the capacity to provide
such emergency services

8. BARRIERS
• inadequate training/skills mix to deliver high-quality
EmONC
• drug procurement challenges and logistical problems in
health facilities
• personnel shortages and lack of equipment
• particularly to deliver CEmONC
• Referral coordination from multiple sectors with
competing interests
• health systems
• infrastructure and public works
• transportation, information and communication
technologies
• marginalized women’s health and rights through restrictive
policies

9. FURTHER READINGS
• 1. Berlac JF, Hartwell D, Skovlund CW, Langhoff-Roos J,
Lidegaard Ø. Endometriosis increases the risk of obstetrical
and neonatal complications. Acta Obstet Gynecol Scand.
2017;96(6):751–60.
• 2. Hutchinson K, Bryant M, Bachman DeSilva M, Price D,
Sabin L, Bryson L, et al. Delayed access to emergency
obstetrical care among preeclamptic and non-preeclamptic
women in Port-Au-Prince, Haiti. BMC Pregnancy Childbirth.
2018;18(1):1–9.
• 3. Ameh CA, Mdegela M, White S, Van Den Broek N. The
effectiveness of training in emergency obstetric care: A
systematic literature review. Health Policy Plan.
2019;34(4):257–70.